James B Turner Principal lecturer, Sheffield Hallam University Richard Ralley Senior lecturer, University of East London Correspondence: james.turner@shu.ac.uk

Abstract

This paper provides a sense of the value of a ‘cognitive’ perspective to therapists when thinking about minds and situations that they encounter. As well as helping to establish knowledge, the science also offers a framework for critical assessment. The paper also aims to prepare the ground for future progress in our understanding of the value of metaphor or picture-based communications. This is part 2 of 2.

Key words

Cognitive neuroscience, metaphors, pictures, images, brain

The first part of this paper appeared in the previous edition of Mental Health Nursing (October/November 2019 issue).

Structures in the brain

The brain is divided into two asymmetrical halves or hemispheres. Each hemisphere develops in a rather specialised way, carrying out specific functions.

McGilchrist (2010) notes that the brain, like the universe, has no profound symmetry and is in fact profoundly asymmetrical. Generally both sides of the brain share similarities, with the exception of the hippocampus being in the left hemisphere and the amygdla being in the right hemisphere. The brain has been described as having three layers that communicate in a left-right and back-to-front manner (and visa versa).

The oldest layer is the brain stem, which connects to the spinal cord, with the medulla oblongata regulating body functions (such as total peripheral resistance/blood pressure) and automatic and reflex actions (Voke, 1986). This has been described as our ‘reptilitan brain’ (Carter, 2003), and is connected closely with the cerebelllum, our little or ancient brain, which has been superceded in modern humans by the cerebral cortex.

The second layer, the mid-brain, holds the parts that deal with emotion, such as the thalmus, hypothalmus, amygdla, and hippocampus – sometimes called the ‘limbic system’ or our paleomammalian brain (Carter, 2003). The mid-brain is densly connected to the orbitofrontal cortex (Wilkinson, 2006).

Emotions are the underlying mechanisms that create body states and actions. There is no action without a chemical synapse, and in order to prepare a body for specific action it is argued that there needs to be an emotion (Carter, 2003).

LeDoux (2002) notes the components necessary here are an emotion system, a memory system and a feeedback system from the body. Feelings are both stimulated by the mind and messages sent to the body and stimlated by the body and messages sent to the mind, with a sense of these being constantly monitored for internal and external stimuli (Carter, 2003).